Zoraster, R., Vanholder, R., and Sever, M. (2007). Disaster Management of Chronic Dialysis Patients. (Abstract only.) American Journal of Disaster Medicine. 2(2): 96-106.
Patients who are dialysis-dependent (with end-stage renal disease [ESRD]) are at particularly high risk after disasters. Dialysis may be delayed and the authors write that few physicians are experienced or trained in the nondialytic management of ESRD. Strategies such as dietary restrictions, potassium removal via resins and cathartics, and adaptations of acute treatment can help patients who can not receive dialysis. The authors emphasize the need for medical facilities to plan and stockpile medications such as Kayexalate to help minimize morbidity and mortality.